A Bayesian approach to modelling field data on multi-species predator prey-interactions

Multi-species functional response models are required to model the predation of generalist preda- tors, which consume more than one prey species. In chapter 2, a new model for the multi-species functional response is presented. This model can describe generalist predators that exhibit func- tional responses of Holling type II to some of their prey and of type III to other prey. In chapter 3, I review some of the theoretical distinctions between Bayesian and frequentist statistics and show how Bayesian statistics are particularly well-suited for the fitting of functional response models because uncertainty can be represented comprehensively. In chapters 4 and 5, the multi- species functional response model is fitted to field data on two generalist predators: the hen harrier Circus cyaneus and the harp seal Phoca groenlandica. I am not aware of any previous Bayesian model of the multi-species functional response that has been fitted to field data. The hen harrier's functional response fitted in chapter 4 is strongly sigmoidal to the densities of red grouse Lagopus lagopus scoticus, but no type III shape was detected in the response to the two main prey species, field vole Microtus agrestis and meadow pipit Anthus pratensis. The impact of using Bayesian or frequentist models on the resulting functional response is discussed. In chapter 5, no functional response could be fitted to the data on harp seal predation. Possible reasons are discussed, including poor data quality or a lack of relevance of the available data for informing a behavioural functional response model. I conclude with a comparison of the role that functional responses play in behavioural, population and community ecology and emphasise the need for further research into unifying these different approaches to understanding predation with particular reference to predator movement. In an appendix, I evaluate the possibility of using a functional response for inferring the abun- dances of prey species from performance indicators of generalist predators feeding on these prey. I argue that this approach may be futile in general, because a generalist predator's energy intake does not depend on the density of any single of its prey, so that the possibly unknown densities of all prey need to be taken into account

Is primary angioplasty cost effective in the UK? Results of a comprehensive decision analysis

Objective: To assess the cost effectiveness of primary angioplasty, compared with medical management with thrombolytic drugs, to achieve reperfusion after acute myocardial infarction ( AMI) from the perspective of the UK NHS. Design: Bayesian evidence synthesis and decision analytic model. Methods: A systematic review was conducted and Bayesian statistical methods used to synthesise evidence from 22 randomised control trials. Resource utilisation was based on UK registry data, published literature and national databases, with unit costs taken from routine NHS sources and published literature. Main outcome measure: Costs from a health service perspective and outcomes measured as quality-adjusted life years (QALYs). Results: For the base case, the incremental cost-effectiveness ratio of primary angioplasty was pound 9241 for each additional QALY, with a probability of being cost effective of 0.90 for a cost-effectiveness threshold of pound 20 000. Results were sensitive to variations in the additional time required to initiate treatment with primary angioplasty. Conclusions: Primary angioplasty is cost effective for the treatment of AMI on the basis of threshold cost-effectiveness values used in the NHS and subject to a delay of up to about 80 minutes. These findings are mainly explained by the superior mortality benefit and the prevention of non-fatal outcomes associated with primary angioplasty for delays of up to this length

Assessing the effectiveness of primary angioplasty compared with thrombolysis and its relationship to time delay: a Bayesian evidence synthesis

Background: Meta-analyses of trials have shown greater benefits from angioplasty than thrombolysis after an acute myocardial infarction, but the time delay in initiating angioplasty needs to be considered. Objective: To extend earlier meta-analyses by considering 1- and 6-month outcome data for both forms of reperfusion. To use Bayesian statistical methods to quantify the uncertainty associated with the estimated relationships. Methods: A systematic review and meta-analysis published in 2003 was updated. Data on key clinical outcomes and the difference between time-to-balloon and time-to-needle were independently extracted by two researchers. Bayesian statistical methods were used to synthesise evidence despite differences between reported follow-up times and outcomes. Outcomes are presented as absolute probabilities of specific events and odds ratios (ORs; with 95% credible intervals (Crl)) as a function of the additional time delay associated with angioplasty. \ Results: 22 studies were included in the meta-analysis, with 3760 and 3758 patients randomised to primary angioplasty and thrombolysis, respectively. The mean ( SE) angioplasty-related time delay ( over and above time to thrombolysis) was 54.3 (2.2) minutes. For this delay, mean event probabilities were lower for primary angioplasty for all outcomes. Mortality within 1 month was 4.5% after angioplasty and 6.4% after thrombolysis ( OR = 0.68 ( 95% Crl 0.46 to 1.01)). For non-fatal reinfarction, OR = 0.32 ( 95% Crl 0.20 to 0.51); for non-fatal stroke OR = 0.24 ( 95% Crl 0.11 to 0.50). For all outcomes, the benefit of angioplasty decreased with longer delay from initiation. Conclusions: The benefit of primary angioplasty, over thrombolysis, depends on the former's additional time delay. For delays of 30-90 minutes, angioplasty is superior for 1- month fatal and non-fatal outcomes. For delays of around 90 minutes thrombolysis may be the preferred option as assessed by 6-month mortality; there is considerable uncertainty for longer time delays

The functional response of a generalist predator

Peer reviewedPublisher PD

Relative performance evaluation and contract externalities

We consider the incentive characteristics of optimal linear contracts based on relative performance evaluation (RPE) for managers undermoral hazard in imperfectly competitive product markets. Each contract influences the quantity choices of all competing agents causing contract externalities that affect the principals ’ contracting game. We analyze the relations between the optimal extent of RPE and several firm and market characteristics, especially allowing for heterogeneous firm characteristics and imperfectly correlated firm profits. We find non-monotonic comparative static results, which yield an explanation for the mixed empirical results in the literature and may help to improve the empirical evidence regarding RPE

Modeled Health Economic Impact of a Hypothetical Certolizumab Pegol Risk-Sharing Scheme for Patients with Moderate-to-Severe Rheumatoid Arthritis in Finland

To model the American College of Rheumatology (ACR) outcomes, cost-effectiveness, and budget impact of certolizumab pegol (CZP) (with and without a hypothetical risk-sharing scheme at treatment initiation for biologic-na <ve patients) versus the current mix of reimbursed biologics for treatment of moderate-to-severe rheumatoid arthritis (RA) in Finland. A probabilistic model with 12-week cycles and a societal approach was developed for the years 2015-2019, accounting for differences in ACR responses (meta-analysis), mortality, and persistence. The risk-sharing scheme included a treatment switch and refund of the costs associated with CZP acquisition if patients failed to achieve ACR20 response at week 12. For the current treatment mix, ACR20 at week 24 determined treatment continuation. Quality-adjusted life years were derived on the basis of the Health Utilities Index. In the Finnish target population, CZP treatment with a risk-sharing scheme led to a estimated annual net expenditure decrease ranging from 1.7% in 2015 to 5.6% in 2019 compared with the current treatment mix. Per patient over the 5 years, CZP risk sharing was estimated to decrease the time without ACR response by 5%-units, decrease work absenteeism by 24 days, and increase the time with ACR20, ACR50, and ACR70 responses by 5%-, 6%-, and 1%-units, respectively, with a gain of 0.03 quality-adjusted life years. The modeled risk-sharing scheme showed reduced costs of a,notsign7866 per patient, with a more than 95% probability of cost-effectiveness when compared with the current treatment mix. The present analysis estimated that CZP, with or without the risk-sharing scheme, is a cost-effective alternative treatment for RA patients in Finland. The surplus provided by the CZP risk-sharing scheme could fund treatment for 6% more Finnish RA patients.Peer reviewe

Indirect comparison and network meta-analyses : new tools for the assessment of evidence on the relative efficacy of drugs

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